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Based on interview and record review, the facility failed to ensure patients were informed of their rights of furnishing or discontinuing patient care when:

1. Two of 32 sampled patients' (Patient 21 and Patient 31) Conditions of Admission (COA- form serves as the initial consent for treatment while in the hospital) forms were missing from the patients' charts; and

2. Two of 32 sampled patients' (Patient 18 and Patient 23) COA forms did not have a second witness signature when the patients were unable to sign for themselves.

These failures resulted in Patients 18, 21, 23 and Pt 31's COA to not be completed per the hospital's policy and had the potential to deny patients the opportunity to make informed choices regarding their care.

Findings:

1. During a review of Patient (Pt) 21's face sheet (document that provides patient information to include name, date of birth, admit date, reason for visit, insurance information, contact person and more) (undated), the face sheet indicated Pt 21 was admitted on 11/23/21 at 6:10 p.m., with a "Chief Complaint: Anasarca (general swelling of the whole body that can occur when the tissues of the body retain too much fluid)."

During a concurrent interview and record review on 11/30/21, at 10:50 a.m., with the Manager of the Intensive Care Unit (MICU) 1, Pt 21's Electronic Medical records (EMR) for admission 11/23/21 was reviewed. While Pt 21's EMR was reviewed, MICU 1 stated she was unable to locate the COA for Pt 21's admission. MICU 1 stated she believed Pt 21 was transferred from another hospital and would investigate why the COA was not completed.

During a concurrent interview and record review on 11/30/21, at 2:38 p.m., with the Supervisor of Patient Access (SPA), Pt 21's COA was discussed. The SPA stated Pt 21's COA was accidentally marked as completed when the Team Lead for Registration (TLR) misread Pt 21's record as the patient was already discharged. The SPA stated the facility was correcting this issue right now. The SPA stated the expectation was for the COA to be signed the first day the patient was admitted or if medical reasons existed, documentation of why the COA could not be signed, then the registration staff documents that on the COA form and made further attempts.

During a concurrent interview and record review on 11/30/21, at 2:50 p.m., with the Team Lead for Registration (TLR), Pt 21's COA was discussed. The TLR stated there is a patient tracker that shows when new patients need COAs completed, for Pt 21, there was a note on the tracker that indicated the patient was admitted in error, so "I put (wrote on the tracker) no paperwork done, no forms signed and this removed the patient [Pt 21] from the list. Once the patient was removed from the list the facility does not go back to check if the COA was done." TLR stated, "I do not know who put the note in the tracker for this patient [Pt 21]."

During a review of Pt 31's face sheet (undated), the face sheet indicated Pt 31 was admitted on 4/29/21 at 9:39 p.m., with a "Chief Complaint: 30 week acute complete placental abruption (condition during pregnancy when the placenta [organ in the uterus that maintains the baby] separates from the uterus [organ in a woman where offspring are conceived])."

During a concurrent interview and record review on 11/30/21, at 2:44 p.m., with the Manager of Patient Safety (MPS), Pt 31's EMR for admission 4/29/21 was reviewed. While Pt 31's EMR was reviewed, the MPS stated she was unable to locate Pt 31's COA. The MPS stated, "The COA should be documented. [Pt 31] was consented for blood at 9:45 p.m. and that documentation was available, there is no reason why the COA would not be found in the chart."

During a review of the hospital's policy titled, "Conditions of Admission (COA)," dated 12/3/20, the policy indicated, " ... POLICY: All Admissions staff will be familiar with the terms of the 'Conditions of Admission and Treatment' form. All patients will sign a Conditions of Admission and Treatment Form upon registering as a patient at [name of hospital]. GUIDELINES: A. Every patient has a legal right to decide upon the medical treatment he/she is to be given. Therefore, every patient that is admitted to the hospital must sign the Conditions of Admission form granting consent to hospital services. This form must be signed before medical treatment except in the event of an emergency. 1. In some instances, the patient may be unable physically to sign but is able to understand and provide information. If the patient chooses, they can verbally consent to having another individual sign for them. This 'verbal consent' must be documented and witnessed by two staff members ... 2. In the event that the patient's medical/mental condition does not allow the patient to sign, the registrar will document the inability to sign in the signature field ... c. All packets completed as unable, will be cosigned by a second staff member (registration or nurse) ..."

2. During a review of Pt 18's face sheet (undated), the face sheet indicated Pt 18 was admitted on 11/27/21, at 12:54 p.m., with a "Chief Complaint: ACUTE VACCINE HYPOXEMIC RESPIRATORY FAILURE (an abnormally low concentration of oxygen in the blood causing shortness of breath and increased rate of breathing)."

During a concurrent interview and record review on 11/30/21, at 10:30 a.m., with Clinical Educator (CE) 1, Pt 18's EMR for admission 11/27/21 was reviewed. While Pt 18's EMR was reviewed with CE 1, the COA dated 11/27/21 had the following statement on the signature line, "Due to verbal protocol verbal consents obtained," and on the witness signature line, one witness's signature was present.

During a review of Pt 23's face sheet, undated, the face sheet indicated Pt 23 was admitted on 11/22/21, at 3:39 p.m., with a "Chief Complaint: Urosepsis (an infection of the urinary tract that spreads to the kidneys)."

During a concurrent interview and record review on 11/30/21, at 11:15 a.m., with the MICU 1, Pt 23's EMR for admission 11/22/21 was reviewed. While Pt 23's EMR was reviewed with MICU 1, the COA dated 11/22/21 had the following statement on the signature line, "PT (patient) NOT ABLE TO SIGN DUE TO MEDICAL CONDITION," and on the witness signature line, one witness's signature was present.

During an interview on 11/30/21, at 2:40 p.m., with the SPA, the SPA stated if a patient was unable to sign due to a medical condition, the expectation was that there were two witness signatures from the staff. The SPA stated if the patient can give a verbal consent, the expectation was there were two witness signatures from staff. The SPA validated Pt 18 and Pt 23's COA forms only had one witness signature and it was expected a second witness should have signed.

During an interview on 12/3/21, at 10:03 a.m., with the Chief Nursing Officer (CNO), the CNO stated the expectation was for staff to follow the policies and procedures of this hospital.

During a review of the hospital policy titled, "Conditions of Admission (COA)," dated 12/3/20, the policy indicated, " ... POLICY: All Admissions staff will be familiar with the terms of the "Conditions of Admission and Treatment" form. All patients will sign a Conditions of Admission and Treatment Form upon registering as a patient at [name of hospital]. GUIDELINES: A. Every patient has a legal right to decide upon the medical treatment he/she is to be given. Therefore, every patient that is admitted to the hospital must sign the Conditions of Admission form granting consent to hospital services. This form must be signed before medical treatment except in the event of an emergency. 1. In some instances, the patient may be unable physically to sign but is able to understand and provide information. If the patient chooses, they can verbally consent to having another individual sign for them. This "verbal consent" must be documented and witnessed by two staff members ... 2. In the event that the patient's medical/mental condition does not allow the patient to sign, the registrar will document the inability to sign in the signature field ... c. All packets completed as unable, will be cosigned by a second staff member (registration or nurse) ..."

Based on interview and record review, the hospital failed to ensure licensed nurses adhered to the policies and procedures (P&P) of the hospital when:

1. Three of 32 sampled patients (Patient [Pt] 20, Pt 24 and Pt 25) were administered pain medication, and reassessment was either not completed or not completed within a timely manner per the hospital's P&P titled "Pain, Assessment and Management".

This failure had the potential for Pts 20, 24, and 25 to continue to be in pain and to not have their needs reassessed in a timely manner.

2. Five of 13 sampled crash carts (a wheeled container carrying medicine and equipment for use in emergency resuscitation) were not monitored each shift per the hospital's P&P titled, "Crash Cart Management".

This failure had the potential to put patients at risk of not having their needs met if the crash cart was needed in an emergent situation.

Findings:

1. During a review of Pt 20's face sheet (document that provides patient information to include name, date of birth, admit date, reason for visit, insurance information, contact person and more), undated, the face sheet indicated Pt 20 was admitted on 11/29/21, at 8:34 a.m., with a " ...Chief Complaint: ALTERED MENTAL STATUS (patient's level of attentiveness and mental processes are affected may not be alert and oriented), RESPIRATORY FAILURE (difficulty breathing)..."

During a concurrent interview and record review on 11/30/21, at 11:14 a.m., with the Manager of Intensive Care Unit (MICU) 1, Pt 20's Medication Administration Record (MAR) dated 11/29/21 was reviewed. Pt 20's MAR indicated Pt 20 received fentanyl (strong pain medication) 50 mcg (micrograms- unit of measurement) intravenously (IV-through a vein) on 11/29/21 at 18:44 (6:44 p.m.), for a six out of eight CPOT (CPOT- Critical Care Pain Observation Tool- used for patients critically ill or have been intubated [insertion of a tube either through the mouth or nose and into the airway to aid with breathing]) score. MICU 1 stated she was unable to locate a pain reassessment score after the fentanyl was given and IV pain medication should be reassessed within 30 minutes after administration.

During a review of Pt 24's face sheet, undated, the face sheet indicated Pt 24 was admitted on 11/28/21, at 7:56 p.m., with a " ...Chief Complaint: SOB (Shortness of breath) ..."

During a concurrent interview and record review on 11/30/21, at 12:02 p.m., with MICU 1, Pt 24's MAR dated 11/29/21 was reviewed. Pt 24's MAR indicated Pt 24 received morphine (strong pain medication) 2 mg, IV for moderate pain level of 4-6 (pain scale, rates their pain on a scale of zero to ten. Zero means no pain, and ten means the worst possible pain) on 11/29/21 at 6:08 a.m. MICU 1 stated she was unable to locate a pain reassessment score after the morphine was administered and IV pain medication should have been reassessed within 30 minutes after administration.

During a review of Pt 25's face sheet, undated, the face sheet indicated Pt 25 was admitted on 11/23/21, at 7:23 p.m., with a " ...Chief Complaint: MULTILOBAR PNEUMONIA (lung infection involving two or more lobes of the lungs), COVID-19 (Coronavirus - an illness caused by a virus that can spread from person to person, this virus has spread throughout the world) ... "

During a concurrent interview and record review on 11/30/21, at 12:15 p.m., with MICU 1, Pt 25's MAR dated 11/24/21 was reviewed. Pt 25's MAR indicated Pt 25 received one [brand name for hydrocodone-acetaminophen] (oral pain medication) 10 mg-325 mg orally for a pain level of 8 out of 10 using a verbal pain scale on 11/24/21 at 6:40 p.m. MICU 1 stated Pt 25's pain reassessment was completed on 11/25/21 at 12:02 a.m., approximately five hours and 22 minutes after the [brand name of hydrocodone-acetaminophen] was administered. MICU 1 stated oral pain medication should have been reassessed within one hour after the patient received it.

During an interview on 12/1/21, at 1:30 p.m., with the Accreditation Regulatory Compliance Manager (ARCM), the ARCM stated the nurses that should have reassessed Pt 20 and Pt 24 after the pain medication was administered were not available for interview.

During an interview on 12/1/21, at 2:03 p.m., with Registered Nurse (RN) 13, RN 13 stated she was the day shift nurse for Pt 25 on 11/24/21; she did give Pt 25 the [brand name of hydrocodone-acetaminophen] for pain and informed the night shift nurse that she gave the pain medication last at 6:40 p.m. RN 13 stated oral pain medication should be reassessed within one hour after administration to see if the medication had worked or decide if the patient may need something else and contact the doctor, if needed.

During an interview on 12/1/21, at 2:07 p.m., with the Manager of the 4th and 7th floor (MG), the MG stated the night nurse did not reassess Pt 25's pain until midnight. The MG stated the expectation was to reassess pain levels within 30 minutes after an IV pain medication was given and with one hour for oral pain medication. The MG stated it was important to reassess the patients' pain after pain medication was administered to see if it had been effective and to advocate for the patient and call the doctor if it has not been effective and something more was needed.

During an interview on 12/1/21, at 2:15 p.m., with MICU 2, MICU 2 stated the expectation for pain reassessment was within 30 minutes after IV pain medication was administered and within one hour after oral pain medication was administered. MICU 2 stated it was important to reassess after pain medication, the pain medication was administered to make sure the patient did not have an adverse reaction (undesired harmful effect resulting from a medication) like lethargic (sleepiness caused by the medication) or decreased breathing and to make sure the medication worked. MICU 2 stated if the medication did not work, then the nurse could call the doctor to discuss the patients' needs.

During an interview on 12/1/21, at 2:50 p.m., with the ARCM, the ARCM stated the nurse that should have reassessed Pt 25 after the pain medication was administered was not available for interview.

During an interview on 12/3/21, at 10:03 a.m., with the Chief Nursing Officer (CNO), the CNO stated the expectation was for the nurses to follow the policies and procedures of this facility. The CNO stated it was important to do a pain reassessment to make sure we (the hospital) have taken care of the patients' pain adequately and decide if further actions were needed if the pain was not under control, such as calling the doctor for further orders.

During a review of the hospital's P&P titled, "Pain, Assessment and Management," dated 1/28/20, the P&P indicated, " ... POLICY: ... [name of hospital] staff is to provide careful assessment of pain levels, timely and appropriate interventions, accurate evaluation of those interventions, communication of the effectiveness of interventions to other health care workers ... GUIDELINES: ... D. The patient's self-report of pain is obtained and recorded on the Vital Signs Flow Sheet. 1. Using the appropriate tool 2. Each and every time Vital Signs are taken a. Or at least once per shift b. At a reasonable interval, after every pain intervention to determine effectiveness *No more than thirty (30) minutes after IV analgesic. * No more than sixty (60) minutes after PO (by mouth) analgesic ..."

2. During a concurrent observation and record review, in the Emergency Department (ED) on 11/29/21, at 2 p.m., two crash carts were observed to have missing required checks. The facility form titled, "CRASH CART CHECKLIST UNIT: ED (green) MONTH/Year 11/2021" indicated, "Defibrillator [machine used to control heart movement by application of an electric current to the chest wall or heart] /pacer [referring to the pads used by the defibrillator]/record check, oxygen level, suction present, crash cart lock # (number) must be checked and this form signed in appropriate column every shift, every working day per policy. Please make note if Unit is closed". The form indicated on November 19th day shift and the 28th night shift, there were missing crash cart checks that were required each shift. A second form title, "CRASH CART CHECKLIST UNIT: ED (green peds [pediatric kids]) MONTH/YEAR: 11/2021" indicated on November 8th and 9th night shift, and on the 24th day shift, there were missing crash cart checks that were required each shift.

During a concurrent interview and record review on 11/29/21, at 2:10 p.m., with the Director of Emergency Department (DED) while in the ED, the two crash carts' checklists titled, ""CRASH CART CHECKLIST UNIT: ED (green) MONTH/Year 11/2021" and "CRASH CART CHECKLIST UNIT: ED (green peds [pediatric kids]) MONTH/YEAR: 11/2021" were reviewed. The DED stated, "If you have a patient that rapidly declines you need to make sure your equipment is ready to go." The DED stated it was really important for them (the staff) to check the crash carts every shift, "I do not know why these checks were missed" but we will look into it.

During a concurrent interview and record review in the Imaging Department on 11/29/21, at 2 p.m., a crash cart was observed to having missing required checks. The facility form titled, "CRASH CART CHECKLIST UNIT: X-Ray [a photographic or digital image of the internal composition of something] MONTH/Year 9/2021" indicated, "Defibrillator/pacer/record check, oxygen level, suction present, crash cart lock # must be checked and this form signed in appropriate column every shift, every working day per policy. Please make note if Unit is closed". On September 11th night shift and the 12th of day shift, there were missing crash cart checks that were required each shift. A second form titled "CRASH CART CHECKLIST UNIT: X-Ray MONTH/Year 10/2021" indicated on October 22nd, 29th, and 30th during the night shift, required checks were missing from the form.

During a concurrent interview and record review on 11/29/21, at 2:10 p.m., with the Interim Director of Imaging (IDI), the documents titled, "CRASH CART CHECKLIST UNIT: X-Ray MONTH/Year 9/2021" and "CRASH CART CHECKLIST UNIT: X-Ray MONTH/Year 10/2021" were reviewed. The IDI stated, "We are open 24 hours a day" and the expectation was for the crash carts to be checked every shift, so the carts are ready when needed.

During a concurrent observation and record review in the Pre (before) and Post (after) Operative Department (POD) on 11/29/21, at 2:21 p.m., two crash carts had missing required checks. The facility document titled "CRASH CART CHECKLIST UNIT: POD MONTH/Year 11/2021" indicated, "Defibrillator/pacer/record check, oxygen level, suction present, crash cart lock # must be checked and this form signed in appropriate column every shift, every working day per policy. Please make note if Unit is closed". On November 3rd, 5th 11th, 12th, 18th, 20th, 21st, 23rd, 24th, on the night shifts, there were missing crash cart checks that were required each shift. A second titled, "CRASH CART CHECKLIST UNIT: POD [pediatric] MONTH/YEAR: 11/2021" indicated on November 3rd, 5th, 11th, 12th, 14th, 18th, 20th, 21st, 23rd, 24th on the night shift and the 8th, 14th day shift, there were missing crash cart checks that were required each shift.

During a concurrent interview and record review on 11/29/21, at 2:30 p.m. with the Shift Manager (SM) in the POD, the documents titled, "CRASH CART CHECKLIST UNIT: POD MONTH/Year 11/2021" and "CRASH CART CHECKLIST UNIT: POD [pediatric] MONTH/YEAR: 11/2021" for the POD were reviewed. The SM stated on the days where the crash cart were not checked, the crash carts should have been checked and signed off in the book. The SM stated that it was important to have the crash carts ready in case they were needed.

During an interview on 12/3/21, at 10:03 a.m., with the Chief Nursing Officer (CNO), the CNO stated it was the expectation the staff followed the policies and procedures of this facility. The CNO stated, "You never know when you are going to need it [the crash cart] ... equipment can fail you need to know and don't want to find out at the wrong time and it affects patient care."

During a review of the hospital's P&P titled, "Crash Cart Management," dated 1/24/19, the P&P indicated, " ... I. POLICY: ... Crash Carts, defibrillators with external pace making capability will be checked each shift in all patient care areas to verify contents, cleanliness, and functionality ... III. GUIDELINES: A. Crash Cart Check Process: 1. Designated Registered Nurses will check the Crash Cart each shift and document their findings on the Crash Cart Checklist ..."

Based on observation, interview and record review, the facility failed to ensure staff implemented its infection prevention and control program policies and procedure to prevent and control the transmission of infections when one of one Registered Nurses (RN 5), performed a PICC (peripherally inserted central catheter- long thin tube that is inserted in a vein, used to give medications or liquid nutrition) line dressing (a piece of soft material that covers and protects a part of the body) change on Patient (Pt) 32, and during this process, RN 5 did not remove his soiled (dirty) gloves after the removal of Pt 32's dressing, did not perform hand hygiene (wash hands by application of an alcohol-based hand rub to the surface of or by washing hands with the use of soap and water), and donned (put on) sterile gloves (gloves made specifically to aid in the prevention of wound infections) over the soiled gloves.

This failure had the potential to put Pt 32 at risk of cross contamination (the process by which bacteria or other microorganisms are unintentionally transferred from one substance or object to another, with harmful effect), thus putting Pt 32 at risk of getting an infection.

Findings:

During a review of Pt 32's face sheet (document that provides patient information to include name, date of birth, admit date, reason for visit, insurance information, contact person and more), undated, the face sheet indicated Pt 32 was admitted on 11/21/21 at 5:11 p.m., with "Chief Complaint: ACUTE ALCOHOL WITHDRAWAL (symptoms that occur when someone stops using alcohol after a period of heavy drinking- headaches, nausea, tremors [involuntary quivering movement], anxiety [feeling of worry, nervousness or unease], hallucinations [perception of something not present], and seizure [a sudden attack of illness causing the patient to shake]), ACUTE HPOXEMIC RESPIRATORY FAILURE (patient does not have enough oxygen in their blood but levels of carbon dioxide are close to normal), ALCOHOLIC SEIZURE (caused by withdrawal from alcohol)..."

During an observation on 12/1/21, at 9:35 a.m., in Pt 32's room, with the Manager of Intensive Care Unit (MICU) 1, RN 5 changed Pt 32's left upper arm PICC line dressing. RN 5 wore gloves, removed Pt 32's dressing to the left upper arm, put on sterile gloves over his soiled gloves, and proceeded to clean the insertion site (where the tube is placed into the skin) of the PICC line. MICU 1 confirmed RN 5 did not remove his dirty gloves, did not perform hand hygiene, and put on sterile gloves, over his soiled gloves.

During an interview on 12/1/21, at 9:45 a.m., with MICU 2, who is currently the ICU Manager, in the ICU, MICU 2 stated, " ... No one should have put sterile gloves over his dirty gloves. He [RN 5] should have removed his dirty gloves, cleaned his hands before putting on sterile gloves." MICU 2 stated it was the expectation (what he mentioned above), and if not done this way, it placed the patient at risk for cross contamination and placed the patient at risk of getting an infection.

During an interview on 12/3/21, at 10:03 a.m., with the Chief Nursing Officer (CNO), the CNO stated, "That is not acceptable [that RN 5 put sterile gloves over dirty gloves and didn't wash his hands], we hold our travel nurses to the same standard and the expectation is that you do it properly [a sterile dressing change]."

During a review of the hospital's document titled, "Skills Central Venous Catheter: Maintenance and Dressing Change ...," dated 12/1/21, the hospital's document indicated, " ... Ensure appropriate care of the access device and system to decrease the risk of central line-associated blood stream infections (CLABSI) ... Dressing Change ... 14. Remove gloves, perform hand hygiene, and don sterile gloves ..."

During a review of the hospital's policy and procedure (P&P) titled, "Hand Hygiene," dated 3/25/20, the P&P indicated, " ... POLICY: It is the policy of [name of hospital] that all healthcare workers shall perform appropriate hand hygiene according to the Centers for Disease Control and Prevention (CDC) guidelines as defined in this policy ... PROCEDURE: A. Indications for Hand Hygiene ... 3. Health care workers shall decontaminate hands using alcohol-based hand rub or washing with soap (plain or antimicrobial) and water under the following circumstances: a. Before and after patient contact b. Before donning sterile gloves ... i. After removing gloves ..."

Based on interview and record review, the facility failed to develop and implement a policy and procedure for an intraamniotic infection (infection of the tissues around the fetus), also known as chorioamnionitis (chorio- is an infection that can have adverse outcomes for both the mother and baby, during labor and after delivery of baby) that is a nationally recognized by The American College of Obstetrics and Gynecologist (ACOG).

This failure had the potential to result in maternal infections to go undetected.

Findings:

During an interview on 11/30/21, at 12 p.m., with Registered Nurse (RN) 3, RN 3 stated the hospital did not have a policy for chorio.

During an interview on 12/1/21, at 7:40 a.m., with RN 1, RN 1 stated there was no policy for chorio.

During an interview on 12/1/21, at 8:53 a.m., with the Director of Quality (DQ), the DQ stated there was no policy for chorio.

During an interview on 12/1/21, at 10:19 a.m., with the Director of Obstetrics/Labor & Delivery (DOBLD), the DOBLD stated there was no policy for chorio. The DOBLD stated she thought it was important to have a policy for chorio and there should be one.

During an interview on 12/1/21, at 10:20 a.m., with the Educator of Obstetrics/Labor & Delivery (EOBLD), the EOBLD stated there was no policy for chorio. The EOBLD stated, "How do we address chorio if there is no policy for it."

During an interview on 12/1/21, at 2:20 p.m., with the Manager of the Intensive Care Unit (MICU) 1 (formerly the Quality and Patient Safety Program Manager), MICU 1 stated there was no policy for chorio.

During an interview on 12/1/21, at 3:32 p.m., with the Senior Director of Patient Care Services (SD) (formerly Director of Obstetrics/Labor & Delivery), the SD stated there was no policy for chorio.

During an interview on 12/2/21, at 7:46 a.m., with RN 4, RN 4 stated there was no policy for chorio.

During an interview on 12/2/21, at 1:15 p.m., with RN 2, RN 2 stated there was no policy for chorio.

During a professional reference reviewed retrieved from https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2017/08/intrapartum-management-of-intraamniotic-infection.pdf, titled "Intrapartum Management of Intraamniotic Infection" dated August 2017, " ...Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua (lining of the uterus during pregnancy and is shed after delivery). Intraamniotic infection is a common condition noted among preterm and term parturients (a women in labor)... Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia (a serious disease that can make it difficult to breathe), meningitis (a serious illness that affects your brain and spinal cord), sepsis, and death, as well as long-term infant complications such as bronchopulmonary dysplasia (a serious lung condition that affects newborns) and cerebral palsy (loss or impairment of movement caused by brain damage that occurs before birth, during birth or immediately after birth) ... Maternal morbidity from intraamniotic infection also can be significant, and may include dysfunctional labor requiring increased intervention, postpartum uterine atony (failure of the uterus to contract after delivery) with hemorrhage (large loss of blood), endometritis (inflammation of the lining of the uterus), peritonitis (inflammation of the membrane that lines your inner abdominal wall that covers your organs), sepsis, adult respiratory distress syndrome and, rarely, death... Conclusion ...Intraamniotic infection is a common condition noted among preterm and term parturients. Recognition of intrapartum intraamniotic infection and implementation of the treatment recommendations are essential steps that can effectively minimize morbidity and mortality for women and newborns. Timely maternal management together with notification of the neonatal health care providers will facilitate appropriate evaluation ..."